You don’t need to be reminded how expensive it is for
businesses to provide health care coverage for their employees. You see the
exorbitant, constantly increasing costs on a daily basis, and you’ve probably
given a lot of thought to finding ways to cut your company’s health care
expenses. One of the best ways to reduce your health care expenditures is to
make sure the medical bills you receive are correct. Believe it or not, billing
mistakes are very common, and a lot of companies spend much more on health care
than they should be spending.
The simple truth is that the medical billing process is
confusing. Doctors’ offices and hospitals use pre-defined codes in the billing
process to document the services provided. Medical coders take a look at what
services were performed for the patient, assign the proper codes, and create a
bill to be paid by the company offering workers’ compensation. Unfortunately,
coding is a complex process, and mistakes are often made.
Today, we’re going to take a look at one particular modifier
used in medical bill coding: Modifier 51. This commonly misused and
misunderstood modifier can save companies money when applied correctly. With
that in mind, here’s what you need to know about Modifier 51:
·
For
multiple procedures: When multiple medical procedures that are commonly
performed together are carried out during the same session or on the same day,
Modifier 51 is used in bill coding to let the payer know that two or more
procedures are being reported on the same day. This allows the payer to get a
discounted rate for the additional procedures performed during the session
(more on that below).
·
Offers
discounted rates: Multiple surgeries performed during the same session
may be billed at a discount using Modifier 51. The way it works is the surgery
with the highest fee schedule value is paid at 100 percent of the scheduled
amount. The rest of the surgeries performed during the session are paid at 50
percent of the fee schedule. This can add up to significant savings for the
company.
·
There are
exceptions: Modifier 51 is commonly confused with Modifier 59. While
Modifier 51 is used for multiple procedures that are commonly performed
together, Modifier 59 is used when multiple distinct procedures are performed.
For example, if the same procedure has to be performed on multiple sites of the
body requiring separate incisions (such as removing tumors from different parts
of the body) or if two totally distinct procedures are performed, Modifier 59
would be used. Even when Modifier 59 is
indicated, the discounted multiple procedure rate applies. Modifiers 51 and 59 are never applied to the
primary procedure.
Sometimes, providers will incorrectly use Modifier 59 when
they should be using Modifier 51 and offering payers reduced rates. That’s why
it’s so important that you have someone in your corner who understands the ins
and outs of medical bill coding and who can ensure the proper modifiers are
used so your company isn’t billed incorrectly or unfairly.
Exclusive post about on medical bill coding, I like your good service.I always appreciate your post.I’m really amazed with your posting skills as well as with the layout on your blog site.
ReplyDeleteMedicare Billing
The article provided by you is very nice and it is very helpful to know the more information.keep update with your blogs .I found a article related to you..once you can check it out......
ReplyDeleteFree Medical Coding Training
Thanks for your great and helpful presentation I like your good service.I always appreciate your post.That is very interesting I love reading and I am always searching for informative information like this.
ReplyDeleteCPC Certification Training